A day in the life of doctor; Covid edition

Vedangshi Roy Choudhuri

“On difficult days, we work between 28 to 48 hours till we get our replacement medical staff to take over”, said Dr Sumedha Biswas, Intensivist and Anaesthetist working in the COVID ICU ward at Dr D.Y.Patil Medical College and Hospital, Pune, while explaining the tough situation which has fabricated in the city due to an alarming rise of cases over the last month.

On 14th September, Covid infection count in Pune reached the grim milestone of 2 lakh, which is more than Delhi (1.93 lakh) and Mumbai (1.57 lakh) as well. In such strenuous conditions, Health officials of Pune Municipality Corporation (PMC) has been working with various NGO’s and other government departments to create adequate awareness of the pandemic and the necessary precautions to be taken to safeguard the public and health workers with videos, constant advertisements, SMS campaigns, and door to door health checks.

Presently, Dr D.Y. Patil Medical College and Hospital have become a recognized centre for the treatment of COVID 19 patients. Having modern medical facilities, D.Y. Patil’s 1300 bed hospital has specifically cordoned special building blocks to treat pandemic patients. According to Dr Sumedha Biswas, “Our primary goal is to treat the patients with all possible care available while preventing cross-infection to other patients and preventing ourself from becoming carriers.” The hospital’s advanced testing labs have been seeing a surge of patients through 24 hours, and crowd management maintaining adequate social distancing becomes a

challenge. Various non-medical workers have been recruited by the hospital administration to bring the required decorum necessary for the safety of the patients and workers in the hospital.

In accordance with the standards of WHO, the preparation of medical workers to adequately protect themselves in layers of Personal Protective Equipment (PPE) is a ritual that may take more than 30 minutes to wear, which Dr Biswas shared with us. Before wearing the protective layers, ICU doctors and nurses have to finish their meal, complete washroom facilities and leave their phones behind as they can enter and exit the ICU only once a day. After their exit, it takes another 30 to 45 minutes to remove the layers of protection, sanitize themselves from head to toe, and prepare themselves for the outside world. Dr Biswas added, “Our breaks are typically 8 hours apart, so we normally would take a few moments to sit down and relieve me of the PPE which is very hot, remove the face shield and N 95 masks to relieve the compression on the face, take a few minutes to shut our eyes and have a small refreshment such as a juice and then get back to work. Talking to colleagues in the breaks also helps a lot because it’s easier to keep going when you know everybody is going through a similar experience. The camaraderie and a sense of a deeper purpose of doing our best to protect our patients motivate us.”

The explosion of the cases in Pune has skewed and thrown out of control the doctor-patient ratio putting a huge strain on the demand for hospital beds. Dr Biswas shares that the challenge of rising cases is from the working class and the poor, whose inadequate knowledge and care on health and hygiene make them vulnerable to be affected. D Y Patil hospital has divided COVID patient care into three different zones according to the severity of the illness. The fear of contamination and cross infection has forced the creation of the segregation zones as per their conditions, and also helps in keeping ready beds for those who require critical medical attention.

With lockdown being relaxed in phases, the affected cases are rising rapidly. Pune hospitals are gearing up to handle the larger caseloads while doing an effective triage so that the resources reach the patients who are seriously ill and require it more than other patients who are positive but asymptomatic. Currently, Doctors do their screening of patients at the out-patient to gauge their seriousness and diagnose the severity of the patients’ illness. “We do not want to mix the patients, hence after all the details are taken, the symptomatic people are admitted to the ward, while asymptomatic people are advised home isolation,” Dr Biswas added.

The ascending number of casualties of the pandemic takes a toll on medical and non-medical workers emotionally as well. There are reported emotional breakdowns of health workers in COVID ICU. Here the doctors have to not only counsel patients but also motivate nurses and ward boys to be at their best and the top of their service excellence. Dr Biswas stresses on the fact that the success of the recovery of COVID patients lies to a large extent on the non-medical staff in providing the right support and keeping them engaged and away from the fear of being

infected. She and many others have gone through being quarantined periodically in case of suspected infections or contaminations, which became more draining and emotionally exhausting.

As we end the interview, Dr Sumedha Biswas has a smile, and she concludes by saying, “I am taking it one day at a time. Instead of panicking at the massive number of cases and feeling despair, it is better to focus on putting your heart and soul at meticulously treating the patients and at the end of the day, as patients recover and leave the ICU, it gives us a rare sense of satisfaction, and we pat ourselves at the back that we have achieved in saving one more life - that counts and inspires us to continue to serve to our best ability.”

According to reports, the recovery of COVID patients depends on the quality of health care. The efforts of doctors such as Dr Sumedha Biswas and her colleagues are in the frontline, putting in their everything and selfless service to save mankind. The battle is on, and the war is long drawn not only on the financial, economic, and commercial aspects but on the emotional and mental wellbeing of the society. Medical and health workers, also the non-medical workers’ families live in fear of their loved ones who are serving in such hospitals, dreading their safety. The COVID pandemic has brought to the fore the severe test of patience and service of the medical profession and their unquestionable dedication and commitment to save lives. As ordinary people rise to overcome challenges and contribute their extraordinary effort, it can be viewed as a big victory of kindness and being human, which makes it a significant difference to mankind.

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Edited by Purvai Parma Shivam & Stuti Kohli